We want a productive workforce, especially during an economic slowdown. But neglecting employee wellbeing at this crucial time can create backlash for companies’ bottom line. Rather, focusing on a long term and sustainable mental health strategy could save millions of dollars – and retain employees who are productive, collaborative, and resilient.

"…WHO estimated that 54 million people suffered from depression in 2017, costing China approximately $7.8 billion every year."

Burnout is now classified as an occupational phenomenon according to the World Health Organization (WHO), and globally more than 300 million people currently suffer from depression. In China, it is estimated that 173 million people have mental disorders, and the WHO estimated that 54 million people suffered from depression in 2017, costing China approximately $7.8 billion every year.

The return on investment (ROI) into employee wellbeing and a mentally healthy workplace averages to $4.20 for every $1 spent across countries including Australia, Canada, the UK, and Japan. Moreover, businesses are increasingly required by governments and shareholders to undertake social responsibility, with mental health seen as one key area for many countries, including China.

Stress, Depression, and Anxiety

A clinically depressed person may not be able to carry out basic daily tasks such as taking care of themselves, let alone having a sharp mind to solve problems and flourish in a social environment. This has a negative impact on team collaboration and interaction due to the individuals’ changes in behavior, causing misunderstandings or conflict. Severe cases can end in suicides.

In the workplace, depression can cause loss of productivity through increased absenteeism, such as sick leave. Depression can also affect the performance of workers who are present at work – presenteeism, defined as attending work while ill with poor mental health, and working at reduced productivity levels. Burnout costs America $500 billion every year according to the World Economic Forum. Meanwhile, Hong Kong employers lose as much as HKD 12.4 billion due to employees’ mental ill health.

Mental Health Reforms in China

In recent years, China has invested heavily in mental health and made great progress. A significant milestone was the passing of the Mental Health Law that came into effect in May 2013. A stipulation that employers should note is Article 15:

Employers shall create a working environment conducive to the well-being of employees and be concerned about the psychological well-being of employees; relevant education about psychological well-being shall be provided to employee sat certain stages in their careers and to employees in specific jobs.

In alignment with the Mental Health Law, the government initiated the National Plans for Mental Health 2015-2020, and specified mental health’s importance in its Healthy China 2030 Plan. Additionally, coverage of treatment for people with severe mental illness has greatly increased, with more than 10,000 psychiatrists trained in recent years. China has committed to increasing treatment for psychotic disorders by 80% and for depressive disorders by 50% through its 2015-2020 National Mental Health Plans.

Companies to Lead in Reducing Stigma

Stigma is strong, and due to the collective nature of the country, it affect snot only the individual suffering but also their families. In China, people feel pressured to keep their depression or mental illness a secret for fear that they might not be employable or be able to marry, or even be ostracized.

This makes help seeking more onerous than it should be. However, attitudes might be slowly shifting. In a qualitative study in Shanghai, although most respondents were not open to seeking professional help for mental health problems themselves, they were open to others doing so, indicating perhaps a move in the right direction.

Dos and Don’ts for Healthy Workplaces

Different companies will have different needs, and budgets. Below are some common areas decision-makers need to consider – and pitfalls to avoid – when implementing mental health strategies in the workplace.


Different companies will have different needs, and budgets. Below are some common areas decision-makers need to consider – and pitfalls to avoid – when implementing mental health strategies in the workplace.

1. Talk to your employees first

When companies move forward to plan any mental health-related workshops without a comprehensive dialogue with their employees on their concerns and expectations, the workshops conducted would likely be ineffective as any content delivered, however good, would not be targeted at the needs of employees. This wastes resources, time, and money.

We encourage companies to talk to their employees first, and not simply through annual online surveys, but through in-depth discussions and conversations facilitated by an external party so as to get an objective gauge of the common themes of concerns, needs, level of knowledge, and interest of employees.

2. Discuss mental health head on

Corporate resilience training, stress management programs, or uplifting and motivational speeches at annual conferences and offsites are abundant. However, there are times when people just do not have the energy to be happy, plus focusing simply on these so-called “positive demeanors” is a way of denying or sweeping under the rug the existing challenges, especially for those wrought with mental health conditions. When one is clinically depressed or anxious, there simply is no energy to “be happy”.

A more difficult, yet potentially productive, conversation is to help employees and managers understand what burnout and exhaustion looks like, what depression and anxiety looks like, and how stress, when not dealt with, can exacerbate other issues. It is pointing employees to these facts that can help them be aware of when they need to seek out more support before they spiral to dysfunctional states of mind and body. That is the prevention. And prevention is better than cure.

3. Drive wellness initiatives locally

Typical workshops talk about coping with stress at work, how to be resilient, and to thrive in your performance. It is pertinent also to address the major sources of stress triggers that are particular to the locality, instead of a blanket one-size-fits all solutions. Whilst work stress is cited to be the most significant cause in countries as the US and UK, it may not be necessarily so in China. With on the ground experience, we find that most employees are more concerned about the stressors from family.

Mental health training in these cases, is often better angled at supporting employees in their non-work issues such as parenting, rather than loading them with hours of training on positive psychology. Maybe a parent support group or guiding executives how to play with their children would be more apt than a talk on resilience.

4. Build psychological safety

The challenge of stigma, taboo, and the individual employees’ biases and assumptions aside, are common challenges for many companies. Organizations do put effort in arranging training for employees, but it is hard to know who and how many would show up in the end. Many companies mistakenly blame internal publicity and communications, or inadequate preparation. An underlying issue we see is the lack of psychological safety.

Psychological safety is defined as “a shared belief held by team members that the team / organization is safe for interpersonal risk taking.” To walk into the room to discuss psychological issues might be risky for some. They are afraid of repercussions even when in reality these repercussions may not exist. In these cases, the company needs to focus on building a sense of psychological safety amongst employees and teams, so that they feel at ease to learn and to share.

5. Stamp mental wellness into organizational culture

Wellness – especially mental wellness – needs to sit firm and square on the company’s map, transcending company culture, values, and business decisions. It is not just for Human Resources to brainstorm and implement, nor is it to be shoved into Diversity & Inclusion. Organizations who truly want to pioneer mental wellness for employees need to think beyond just providing medical insurance, employee assistance programs, or workshops and lunch time yoga classes. Rather, they need to do deep introspection into the overall work culture they purport.

Companies need to create environments where different opinions could be heard, which also increases a sense of psychological safety. Leadership development offerings, team offsite days, and senior management strategy retreats all need to include elements of mental wellness, be it stress management, emotional awareness, resilience, or any other topics under the umbrella – and the budget needs to be generously allocated.

Healthy Workplaces for a Healthy World

Mentally healthy workplaces support individuals in achieving their optimum productivity, functioning, creativity, and decision-making. This helps companies save costs brought about by ill-health, and maximizes the bottom line with higher productivity. Once knowledge reaches more employees, managers, and executives, a ripple effect can be created for them to pass on this knowledge and awareness to the generations before and after.

And if the education can also potentially reach head or key decision-makers of families, the impact can be extensive. As the ripples enlarge, taboos slowly breakdown, and not only workplaces become mentally healthy, but so do team dynamics, relationships, and individual senses of self.


This article was originally published in the fourth edition of the AmCham China Quarterly, an executive-targeted periodical focused on policy, business, and technology, driven by C-suite perspectives and insights. To subscribe or contribute to the Quarterly, contact our editor: jpapolos@amchamchina.org

To download the full Quarterly, click here.

Parts of this article were adaptedfrom “From treatment to prevention: the role of workplace psychoeducation for mental health in China” written by the same authors and published on Asia Dialogue.